This paper analyzes the present situation of intellectualization of hospital outpatient service building,points out its characteristics and disposition requirement,and proposes the design of intellectualized outpatient service.After rectifying outpatient procedure,our hospital designs and practices the new one,which provides humanism service for outpatient.

OBJECTIVE To investigate the prevelance of hospital infections of sugical patients in neurosurgery department and analyze the risk factors. METHODS Retrospective survey was made for 456 operative inpatients in neurosurgery department from Jan 2007 to Dec 2008. RESULTS Among them there were totally 66 cases of hospital infections (14.3%). 82 case-times of hospital infections (17.98%)were found. The infections were found located mostly in respiratary tract infection (51.51%) and gastro-intestinal tract infection (16.66%). CONCLUSIONS Surgical patients in neurosurgery department are high-risk group of hospital infection. Normalizing nursing adminstration and strengthening monitoring are effective methods to prevent nosomial infections.

Objective To evaluate accuracy of cefoxitin disk testing for detecting oxacillin resistance coagulase-negative staphylococci (MRCNS). Methods 139 clinical coagulase-negative staphylococci (CNS) were detected with ID32 STAPH. Cefoxitin disk and oxacillin disk testing were used to detect MRCNS. PBP2a was tested by latex agglutination us a reference method. Results 139 CNS isolates were identified to 8 species: Staphylococcus haemolyticus , S. epidermidis , S. hominis , S. xylosus , S. saprophyticus , S. auricularis , S. simulans and S. warneri. The sensitivity and specificity for cefoxtin disk and oxacillin disk testing were 99.0% vs. 86.0% and 91.7% vs. 74.4%, respectively. One S. epidermidis strain was identified to affect the sensitivity of cefoxitin disk testing. S. xylosus, S. warned, and S. saprophyticus were major species related to the decrease of specificity of cefoxitin disk testing. S. haemolyticus, S. hominis, S. simulans and S. auricularis were major species related to the decrease of sensitivity of oxacillin disk testing. And the decrease of specificity of oxacillin disk testing were mainly related to S. hominis , S. simulans , S. xylosus , S. auricularis , S. saprophyticus and S. warneri. Conclusions The accuracy of MRCNS detection by cefoxitin disk testing is varied due to different CNS species. So it is necessary to test PBP2a or mecA gene according to CNS species, especially for S. xylosus, S. warned and S. saprophyticus.

Objective To express the novel fibronectin-binding protein Fba of group A streptococcus(GAS)and analyze its immunogenicity,so that to evaluate the immune responses to GAS infection.Methods fba gene was amplified by polymerase chain reaction(PCR)and confirmed by sequencing.Then it was cloned into pGEX4T-2 vector and Fba protein was expressed in E.coli BL21.The protein expression was identified by enzyme-linked immunosorbent assay(ELISA)and Westernblot.The sera from mice infected with GAS and anti-streptolysin-O positive patients were detected using microtiter plates coated with purified Fba protein as antigen.Afterward Balb/C mice were immunized with this purified protein and the sera were collected after the third immunization for the detection of IgG titer.Results It was confirmed by ELISA and Western blot that the recombinant Fba protein had a specific affinity with anti-Fba sera of rabbit.The anti-serum IgG titer of mice imrnunized with Fba protein was up to 1:4800.Conclusions GAS infection or Fba protein immunization are able to induce high serum titer of anti-Fba which could react specifically with the recombinant Fba protein.It indicates that Fba protein has good immunogenicity and antigenicity.So Fba protein could be a GAS candidate vaccine and an important tool to detect anti-GAS titer in GAS infected patients.

Objective The truncated fibronectin-binding proteins A (Fba protein) were cloned and expressed, then animals were immunized with Fba protein and subsequently challenged with group A streptococcus (GAS) to further investigate protective antibodies induced by each domain and determine the most immunogenic domain. Methods Fba proteins, which were divided into four overlaps based on the structural domains, were truncated and expressed. The fba truncated genes were amplified by polymerase chain reaction (PCR) with SSI-9 of GAS as template, and cloned into prokaryotic expression plasmid pGEX-2T and expressed in E. coli BL-21. The products were confirmed by Western blot and purified by affinity chromatography column. Female BALB/c mice were immunized with the four truncated proteins respectively, with phosphate buffered solution (PBS) as control. The serum IgG of mice was detected by enzyme-linked immunosorbent assay (ELISA). After the third immunization, mice were challenged with fatal dose of GAS (M+ Fba+ ) to evaluate the protective rates in each group. The data were compared by analysis of variance and Fisher's exact test.Results Prokaryotic expression plasmids of pGEX-2T/FbaAl, pGEX-2T/FbaA2, pGEX-2T/FbaA3 and pGEX-2T/FbaA4 were successfully constructed and the four truncated proteins were expressed and purified successfully. Serum levels of IgG in each experimental group gradually increased with immunization with Fba protein more times. After the third immunization, the IgG titer against FbaA2 1290.2, P<0. 01). After GAS challenge, four out of eight mice were protected in FbaA2 protein group, while two out of eight mice in FbaAl protein, FbaA3 protein and FbaA4 protein groups,respectively (P<0. 05). Conclusions Four truncated Fba proteins are constructed and expressed successfully. Truncated FbaA2 protein could be able to induce strongest protective immune response.

Objective:To explore the effect of virtual reality (VR)-based baduanjin exercise on the cognition, physical functioning and life quality of elderly persons with mild cognitive impairment (MCI).Methods:Fifty-seven mildly impaired elderly persons were randomly divided into an observation group ( n=29) and a control group ( n=28). Both groups were given routine care and health education in their nursing homes, while the observation group additionally performed 50 minutes of VR baduanjin exercise three times a week for 24 weeks. Both groups were assessed using the Montreal cognitive assessment (MoCA), the Rivermead behavioural memory test (second edition) (RBMT-Ⅱ), a digit-symbol substitution test (DSST) and the Trail Making Test (TMT). The short physical performance battery (SPPB) and Alzheimer′s disease quality of life (QOL-AD) instrument were also administered before and after the 24-week intervention. Results:After the intervention the average MoCA, RBMT-Ⅱ, DSST, TMT-A, SPPB and QOL-AD results of the observation group were all significantly better than before the intervention and better than the control group′s averages. The observation group also performed better on the 5 times sit-to-stand test, the tandem standing test and a walking speed test after the intervention.Conclusions:VR-based baduanjin practice can effectively improve the cognition and physical functioning of mildly impaired elderly persons, as well as improving their quality of life.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.